knee

Question 1

symptoms of meniscal tear

Answer 1

Pain
Swelling
Stiffness
Restricted range of motion
Locking of the knee
Instability or the knee “giving way”
Pain may be referred to the hip or lower back.
tenderness
swelling

Question 2

special tests for meniscal tear

Answer 2

mcmurrays
thassalys

Question 3

patient needs knee xray to exclude differentials if

Answer 3

age 55 or above
patella tenderness only
fibular head tenderness
cannot flex the knee to 90 degrees
cannot weight bear

Question 4

investigations for menischal tear

Answer 4

MRI scan most sensitive
athroscopy gold standard

Question 5

conservative mangement of most acute soft tissue injuries including knee

Answer 5

RICE
rest
ice
compression
elevation

Question 6

management of meniscal tear

Answer 6

NSAIDs
physiotherapy- most important
surgery for repair of meniscus or resection of affected portion of meniscus. not many are good for repair

Question 7

what is the more common cruciate ligament injury to occur

Answer 7

anterior. quite common particularly among athletes

Question 8

the PCL stops the tibia from

Answer 8

sliding backwards in relation to the femur

Question 9

the ACL stops the tibia from

Answer 9

sliding forward in relation to the femur

Question 10

symptoms of ACL injury

Answer 10

pain, immediate swelling, pop sound or sensation
can walk in straight line
bad twisting and turning
deep pain

Question 11

acl is caused by

Answer 11

twisting injury
females more than males

Question 12

acl injury tests and investigations

Answer 12

anterior drawer test
lachmanns test
pivot shift
xray
MRI scan first line
often can have lateral meniscal tear simultaneously, sometimes medial
arthroscopy

Question 13

management acl injury

Answer 13

RICE
NSAIDs
curtches
physio
focused quadriceps programme
arthroscopic surgery- reconstruction, new ligament formed using a graft from another tendon usually hamstring
delayed has better results

Question 14

bakers cyst

Answer 14

politeal cyst
due to degenerative changes
caused by meniscal tears, osteoarthritis, knee injury, inflammatory arthritis

Question 15

presentation of bakers cyst

Answer 15

Pain or discomfort in popliteal fossa
Fullness
Pressure
A palpable lump or swelling- most apparent when standing
Restricted range of motion in the knee (with larger cysts)

ruptured- pain swelling and erythema in surrounding tissues and calf muscles

Question 16

investigations bakers cyst

Answer 16

US first line
MRI

Question 17

treatment for bakers cysts

Answer 17

nothing fro asymptomatic
modified activity
NSAIDs
physio
aspiration
steroid injections
arthroscopic procedures to treat underlying knee conditions

Question 18

cause of meniscal tear

Answer 18

twisting esp in deep flexion
osteoarthritis
medial more common!

Question 19

types of meniscal tear

Answer 19

flap
radial
degenerative
parrots beak
bucket handle

Question 20

MCL tear

Answer 20

most common ligament tear of knee
severe valgus stress, usually contact related

Question 21

presentation of MCL tear

Answer 21

heard a pop or crack
intense pain on medial side
bruising medial knee
unable to carry on
localised swelling

tender medial joint line
painful in full extension

Question 22

investigations MCL tear

Answer 22

x ray to exclude bony injury
mri modality of choice
assess location and severity of injury

Question 23

MCL management

Answer 23

rest, nsaids
physio
brace for comfort
even in athletes
small number of cases get surgery if non operative is failed, usually has other injuries too

Question 24

osteochondritis dissecans

Answer 24

unsure of cause
affects articular cartilage and subchondral bone
can be juvenile or adult
knee most common
hereditary
traumatic
vascular

Question 25

presentation osteochondritis dissecans

Answer 25

activity related pain
recurrent effusions
locking
block to full movement
may have normal history
tenderness
stiffness
wilsons test internally rotate

Question 26

osteochondritis dissecans investigations

Answer 26

x ray
add in tunnel view

MRI shows status of cartilage and subchondral bone